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Feeling constant pressure and swelling in lower part of nose, roof of mouth and headache. What's wrong?

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ENT Specialist
Practicing since : 1991
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Hi Dr. Bhatti:

I have a constant pressure and swollen feeling in the lower part of my nose (more notably on the right side), in the roof of my mouth, and in the left side of my chin. Sometimes the left side of my neck feels swollen and I can feel that my pulse is stronger on this side than on the right side. Occasionally, I get very bad sinus headaches around my left eye. When I get these headaches, the pressure I just described isn't present. When the headache leaves, the pressure returns. My dentist and ENT cannot find anything wrong. My chiropractor told me that my neck is very inflamed. What do you suggest that I do next to try and find out what is wrong?
Posted Fri, 24 Aug 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 8 hours later

Thank you for your query.

1. A Screening plain CT PNS (Para Nasal Sinuses) will once and for all settle the issue whether you have sinusitis or not. Chronic sinusitis should receive a trial of medication initially. You also have swelling and tenderness in the chin, under the jaw and in your neck. These lymph nodes drain the nose, sinuses and throat signifying some mild inflammation there. The throbbing (stronger pulse) in the neck may also be due to this. Get a USG (Ultrasound) and Doppler Study of the Neck done. Have you had cervical spine x-rays done?

2. Blocked sinuses are poorly ventilated and along with stasis of secretions, continuing infection and inflammation is common. Pain and pressure around the eye is common in sinusitis. Inflammation and pus makes it difficult for antibiotics to act. Sometimes, the infection is fungal and hence medication does not help. Hence supportive treatment is required. Local decongestant drops may be used to reduce the pressure.

3. You need to get an ENT Specialist to examine your nose, sinuses and ears again. A nasal swab or any discharge may be sampled for culture and antibiotic sensitivity. A plain CT PNS (Para Nasal Sinuses) will definitely help understand your problem.

4. You may require a further course of antibiotics, pain killers, anti-allergics, decongestants, mucolytics and steam inhalation. This should be done under medical supervision.

5. You may share your CT Scan, Neck USG, Neck X-rays and investigation reports here for more specific treatment options. For example, if your Sinus CT is normal, a Neurologists opinion on neuralgias and migraine will be required. Balloon Sinuplasty may be an option if the sinus pressure persists.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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